Thursday, February 11, 2010

pmh

‘Shall we go through and meet the patient?’‘Just a minute. I need a word.’This front room is too hot and Mrs Cherry is too close. She has that kind of three dimensional anxiety that will point in the same direction no matter how you view it. A set expression, drawn wide, like the hologram of the Cheshire Cat on a credit card. ‘I’ve not been well myself. I’ve had cancer – down there. I’ve had brachytherapy. Do you know what brachytherapy is?’‘Erm – no, I don’t, actually.’‘And you’re a paramedic?’‘A technician. Like a junior paramedic, but still.’‘And you don’t know what brachytherapy is?’‘No.’‘How long’s your training?’‘Basic training ten weeks. A year’s probation on the road.’‘My son’s a consultant neurologist. He works up in London. He’s done research.’‘So what’s brachytherapy, then?’‘Brachytherapy’s when you get radiotherapy internally. From inside. They put it into you, with a machine. Into your vagina. I also suffer from prinzmetal angina. Do you know what that is?’‘I know what angina is.’‘Well I get prinzmetal angina. Have you heard of it?’‘No.’‘Oh. I am surprised. It’s rare, but not that rare. It’s when the coronary arteries go into spasm. Look it up on the internet when you get home. I have to use a spray. The cardiologist took my ECG to America, to an international conference. They were going to operate but he stopped them at the last minute. So you’re not a paramedic?’‘No. I’m a technician.’‘Do you drive the ambulance?’‘Amongst other things. But anyway – what do you need to tell me about your mother?’

But before Mrs Cherry can speak her husband, the son-in-law, Mr Cherry, a pressed and professional man with professional levels of restraint, steps forward. He has a coat folded over one arm, a travel suitcase in the other.‘She won’t want to go to hospital so you’ll have to just take her.’‘Well. We’ll see. Shall we go through and meet the patient?’‘No. No. Before you go in, there’s a few things you need to know.’The two of them begin a sniping crossfire of complaint. Enid has dementia. Enid is aggressive and paranoid. Enid scratches and screams. Enid says she was beaten up and thrown out of bed by her sister who lives down the hall. Enid says she has pain in her side. The doctor thinks it’s serious and wants it investigating.‘Did the doctor leave a letter?’Mr Cherry sighs, puts the suitcase down and hands me the letter. ‘Can you read it?’ he says.‘Just about.’Decreased mobility. Increased confusion. Query UTI and Acopia.I re-fold the letter and Mrs Cherry is there in its place, smiling into me.‘I’ll do my best to sweet talk her,’ she says. ‘You boys be as nice as pie, follow me and just put her in the chair. Hopefully between us we can persuade her to go.’

Enid is stretched out on the bed next door, moaning a little, a hand on her forehead. Mrs Cherry takes that hand and rubs it as she talks.‘Mummy? Mummy dear? These lovely boys here are going to take you to the hospital. Like the doctor said. You’re going for a lovely ride in their ambulance, and they’ll take good care of you, won’t you boys?’‘Yes. Absolutely.’‘I’m cold,’ she says. ‘Shall I put her dressing gown on?’‘There’s no need. We’ve got blankets here.’‘I’ll put her dressing gown on.’She sits Enid up who moans a little but is otherwise quite okay about it all.‘Now no complaining,’ says Mrs Cherry, smiling more intensely. ‘You’ve got to go and that’s that. You know I’ve not been well.’‘You’re off to the hospital,’ says Mr Cherry, supervising from the doorway. ‘No fuss now.’Enid submits to her dressing gown being put on, and drapes her withered legs meekly over the edge of the bed. Mrs Cherry smothers her in encouragement from the sidelines as we help her transfer into the chair and wrap her in blankets. ‘Be a good girl, won’t you? You’ve got two lovely men here who’ll take fantastic care of you, won’t you boys? Now there’s no choice about it. It’s for your own good. The hospital’s a lovely place and they’ll get you better there. Won’t they, boys? Hasn’t she done well? She’s amazing, isn’t she?’Enid patters out some words, shakes her head a little.‘Oh come on, mother,’ says Mrs Cherry, smoothing her white hair down. ‘Don’t start.’ Then to us: ‘There. That wasn’t too bad, now, was it?’

I loved the phrase "a pressed and professional man with professional levels of restraint". I can SO imagine him. Actually it's probably not a phrase but maybe a clause......but I loved it anyway. As ever, great writing. Thanks for taking us there.Nikki

It's interesting in this job, meeting so many people, often in straitened situations, of course, stressed out, coping in different ways. I often wonder what they're like outside of the situation, how they cope normally. I got the feeling with Mrs Cherry that she was pretty spiky generally. Maybe Mr Cherry wasn't so much reserved as well-padded.

BTW - with our CFRs it transpires that they're not allowed to do even the baseline obs any more - no temp, bm, sats, bp. Which is ridiculous, and incredibly frustrating for them. I hope down your way management is a little more enlightened!